Reoperation rates did not differ between chatbot-enrolled and non-enrolled LEP patients (0% vs 1.5%, P=1.000)

Description #

There was no difference in reoperation rates between the LEP patients enrolled in the multilingual SMS chatbot and the non-enrolled historical LEP control: 0% versus 1.5%, P = 1.000. The single reoperation occurred in the non-enrolled control group (an irrigation and debridement with poly exchange). This result is text-only (not depicted in a figure/table).

"There was no difference in reoperation rates between the chatbot cohort and those not enrolled in the chatbot (0% versus 1.5%, P = 1.000). One patient who was not enrolled in the chatbot underwent an irrigation and debridement with poly exchange." (Rainey, 2023, p. S79)

"There was no difference in reoperations between the 2 cohorts." (Rainey, 2023, p. S78)

Methods Context #

What? #ⓘ

The observable: reoperation within the postoperative follow-up window.

"Independent t-tests, Fisher's exact tests, and chi-squared tests were performed to measure the effect that conversational engagement had on ED visits within 90 days, hospital readmissions within 90 days, and reoperations." (Rainey, 2023, p. S79)

How? #ⓘ

Retrospective cohort comparison of LEP patients enrolled in the A-0004ArtifactA-0004Initial AI draftStreaMD multilingual orthopaedic SMS chatbotTo coach total joint arthroplasty (TJA) patients through the perioperative period in their own language via automated text messages, delivering perioperative education and remote monitoring to patients — including those… against a historical control of non-enrolled LEP patients, with rates compared by Fisher's exact test.

"a retrospective review was performed on all patients who underwent total hip or total knee arthroplasty who were also enrolled in a SMS chatbot from 2020 to 2022 at a single institution." (Rainey, 2023, p. S79)

Who? #ⓘ

47 LEP TJA patients enrolled in the chatbot versus a historical control of 68 LEP TJA patients (surgery 2018-2019) not enrolled, at a single academic center.

"A historical control of 68 patients with LEP who did not enroll in the chatbot and underwent a TJA between 2018 and 2019 were identified for comparison purposes." (Rainey, 2023, p. S79)

Other Notes #

A null result (P = 1.000) with a single event across both arms; wired as contradicting the claim that the chatbot reduces reoperations, per the corpus convention that a null opposes the claim it bears on. The study was not powered for this outcome.

Caveats #

• Retrospective single-center chatbot study with only 90-day follow-up The study is a retrospective review at a single academic center, so its patient population may not represent other US regions, and it captured only short-term (90-day / at-least-3-month) outcomes — leaving long-term effects of chatbot engagement unassessed. The authors state that multicenter and prospective investigation, plus study of outcomes beyond 3 months, are needed to validate the findings. These features limit generalizability and preclude causal or durable-effect inference from the outcome comparisons.